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Affiliation



1 Center for International Relations, Osaka University Graduate School of Medicine, Osaka, Japan.







Sachiko Baba et al.






J Obstet Gynaecol Res .



2014 Jan .







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1 Center for International Relations, Osaka University Graduate School of Medicine, Osaka, Japan.





Singh S, Darroch JE.
Singh S, et al.
Fam Plann Perspect. 2000 Jan-Feb;32(1):14-23.
Fam Plann Perspect. 2000.

PMID: 10710702








Spitz AM, Velebil P, Koonin LM, Strauss LT, Goodman KA, Wingo P, Wilson JB, Morris L, Marks JS.
Spitz AM, et al.
JAMA. 1996 Apr 3;275(13):989-94.
JAMA. 1996.

PMID: 8596256








Curtin SC, Abma JC, Ventura SJ, Henshaw SK.
Curtin SC, et al.
NCHS Data Brief. 2013 Dec;(136):1-8.
NCHS Data Brief. 2013.

PMID: 24314113








Darroch JE.
Darroch JE.
Curr Womens Health Rep. 2001 Oct;1(2):102-10.
Curr Womens Health Rep. 2001.

PMID: 12112956


Review.





Hamilton BE, Ventura SJ.
Hamilton BE, et al.
Int J Androl. 2006 Feb;29(1):34-45. doi: 10.1111/j.1365-2605.2005.00638.x.
Int J Androl. 2006.

PMID: 16466522


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Watanabe K, Goto A, Ishii K, Yoshida-Komiya H, Ito S, Ota M.
Watanabe K, et al.
JMA J. 2021 Oct 15;4(4):339-346. doi: 10.31662/jmaj.2021-0033. Epub 2021 Oct 1.
JMA J. 2021.

PMID: 34796288
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Espinoza C, Samandari G, Andersen K.
Espinoza C, et al.
Sex Reprod Health Matters. 2020 Dec;28(1):1744225. doi: 10.1080/26410397.2020.1744225.
Sex Reprod Health Matters. 2020.

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Ogawa K, Matsushima S, Urayama KY, Kikuchi N, Nakamura N, Tanigaki S, Sago H, Satoh S, Saito S, Morisaki N.
Ogawa K, et al.
Sci Rep. 2019 Feb 20;9(1):2365. doi: 10.1038/s41598-019-38999-5.
Sci Rep. 2019.

PMID: 30787379
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Mgaya A, Hinju J, Kidanto H.
Mgaya A, et al.
BMC Pregnancy Childbirth. 2017 Jun 12;17(1):184. doi: 10.1186/s12884-017-1358-9.
BMC Pregnancy Childbirth. 2017.

PMID: 28606111
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Baba S, Iso H, Fujiwara T.
Baba S, et al.
PLoS One. 2016 Nov 10;11(11):e0166345. doi: 10.1371/journal.pone.0166345. eCollection 2016.
PLoS One. 2016.

PMID: 27832177
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Aim:


The paper examines recent time trends, explores potentially influential background factors and discusses prevention strategies of pregnancy among girls under 15 years of age in Japan.




Methods:


Using Japanese government data, we first analyzed time trends of early adolescence (<15 years of age) abortion, live birth and child sexual abuse from 2003 to 2010. Second, we analyzed ecological correlations of early adolescent pregnancy (abortion, live birth and stillbirth) with pregnancy in other age groups, child sexual abuse, and indicators of juvenile victimization and juvenile delinquency, using prefectural data.




Results:


We found that rates of both abortion and live birth in early adolescents have increased since 2005 (annual percent change 5.3% and 2.3%, respectively), despite declining rates in older age groups. The abortion ratio in early adolescence remained the highest among all age groups in Japan. The early adolescent pregnancy rate showed significant correlation with the rates of juvenile victimization of welfare crimes (obscenity, alcohol drinking, smoking and drug use) (Spearman's rank correlation coefficient [rs] = 0.42, P = 0.00) and juvenile delinquency among junior high school students (12-14 years of age) (rs = 0.69, P = 0.00).




Conclusion:


The observed rise in rates of abortion, live birth and child sexual abuse among early adolescents along with strong ecological correlations of their pregnancy rate with juvenile victimization and delinquency indicators suggests that epidemiological investigation and public health programs at the individual and community levels are needed to address the complex social roots of these trends and to produce effective improvements in early adolescent reproductive health.




Keywords:


Japan; epidemiology; induced abortion; pregnancy in adolescence.


© 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.


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Published: 08:10 BST, 10 November 2015 | Updated: 10:13 BST, 10 November 2015
The babies cradled in these young girls' arms could easily be their little brothers or sisters.
But this is Guatemala, a country where nearly a quarter of all babies are born to teenage mothers. Some haven't even reached their milestone 13th birthday - in 2011, 35 new mothers were just 10 years old.
In some ways, the numbers are the less shocking aspect of this epidemic, which puts both the mothers and their children in mortal danger. 
Nearly all teenage births, 90 per cent, involve a relative, an uncle or cousin - a horrifying 30 per cent of children are born as a result of the girls' own father.  
The trauma of what has happened to these girls, many too young to understand what was happening to them and some who had never heard of contraception, is etched on the faces of the mothers, captured by Swedish photographer Linda Forsell.
Growing up too soon: Gloria is just 13, and became pregnant by a 22-year-old nightclub DJ. Gloria doesn't feel like she was raped - but she barely seems to know how it happened. In Guatemala, the church holds a lot of sway and it blocks attempts at sex education. The result is played out in the numbers - last year some 5,100 girls under 14 became pregnant, up from 4,354 in 2013
Too soon: Gloria's baby came prematurely - or so she thinks. She didn't know when her last period was before she got pregnant. Poignantly, she is not allowed to accompany her boyfriend to work, because it is past her bedtime
Over the course of repeated trips during a two year period, they told her their stories as she worked: a girl who was tied to a tree while a 53-year-old man raped her, a girl who was sold to her husband, 22, aged 12, a girl so young she didn't know she could get pregnant when a 28-year-old began bringing her gifts.
In 2014, there were 5,100 babies born to teen mothers under the age of 14, up from 4,354 the year before.
The government is attempting to crack down on the epidemic, however: this week a new law was passed, increasing the legal age for marriage to 18. Previously, it had been just 14.
Innocence: Lilian fell pregnant with her son Luis David, one, when she was 11. Her uncle is Luis's father. He began raping her when she was nine. Unlike many cases in Guatemala, he convicted for what he did - but only got a two-month restraining order to keep away from her
Family: Still a child herself, Lilian plays with her brothers and son Luis David, who are all so close in age they look like siblings enjoying playtime together
But in 2012 there were 2,000 known cases of under-14s giving birth to a child, yet just eight convictions were successful. That figure led Guatemala's children's prosecutor, Harold Flores, to describe the country's high teen pregnancy rate as a 'scourge'.
The problem, Mirna Montenegro, the head of Guatemala's Sexual and Reproductive Health Observatory (OSAR), suggested, stemmed from men's belief that a woman is their 'property and possession'. 
' We've heard fathers say 'She's my daughter and my property so I will do what I want with her',' revealed Montenegro.
Comfort: Heidy was 12 when she became pregnant with son Marcos David. For girls like her having a baby so young spells the end of their education. Not at school, she finds solace in the church, which, ironically, creates barriers for authorities dealing with teen pregnancies
Teen mum: Michelle was 13 when she was raped by a man, 53, as she walked home from school. He chased her and tied her to a tree, which led her to became pregnant with daughter, Erica. Michelle is now pregnant for the second time after her mother sold her to a man in return for a bed. In Guatemala, until this month, marriage at 14 was legal
Trauma: Michelle did not want to hold her daughter (pictured in their home) for six months after she gave birth to her. How she had come into the world had left too much of a scar for the young girl
The use of rape is a legacy of Guatemala's civil war, which ran for 36 years until the mid-1990s, says Montenegro. It is thought 100,000 women were raped during those violent years, with both the CIA-backed right wing generals and left wing insurgents using it as a weapon.
Thousands of women of all ages are still raped every year. About 10,000 women are brave enough to report it - just one in 10 of them will ever get see their attacker convicted. 
That figure, says Forsell, is 'not even the tip of the iceberg'.
Carolina Escobar, director of La Alianza Guatemala, which runs shelters in the country, told the Tico Times : ' Guatemala has a culture, highly tolerant to sexual violence against girls and women, which normalizes – and even justifies in several cases – this type of violence. 
'It's a taboo not discussed by our society.' 
Threats: Jennifer, 14, gave birth to Anderson two years ago. The father - thought to be a criminal - has threatened the family several times since he was born. According to a 2009 law, sex with a child under 14 is defined as rape, but the family are too scared to report him
Fighting for her future: Remarkably, Jennifer is now back in school, thanks to a local charity
Angelic: Baby Anderson sleeps as the sun pours in the window. He is growing up in a country where violence against women is at horrific levels, with some 10,000 reporting rape every year. The real number of victims is thought to be far higher
Life-threatening: Yet childbirth at such a young age is also dangerous. Complications during birth are the second highest cause of death in girls aged 15 to 19 in Guatemala. Amelia, 14, had to have a cesarian section birth because her uterus would not contract properly
Painful: Later, Amelia suffered from a severe adema, or swelling. Pictured: The blood stained floor after Amelia gave birth
But, says Forsell, the on-going cycle of rape and teenage pregnancy is not just a problem perpetuated by men.
During her time, she met mothers who sold their daughters, women who did not report what had happened because it was simply thought of as normal, and husbands who married 12-year-old girls who did not believe they had done anything wrong. 
'Let me be clear: these men have to serve their time.There has to be justice for these people, but without women ti would not be possible for this system to exist,' she told MailOnline.
 'A lot of the time these people are not evil - they just believe it is okay.' 
Indeed, families will go out of their way to cover up the pregnancy. Forsell believes the figure could be as high as 30 per cent.
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